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Cygnus Matrix

Pennsylvania rates for HCPCS Q4199

Cygnus matrix, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

Facilitymedian $112 · 10th–90th $112$4680%50%90th$112Professionalmedian $112 · 10th–90th $112$1910%50%90th$112$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$123.03
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$389.05
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$446.68
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$275.42
Typical High
$407.38
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$218.78
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$112.20
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$112.20
Typical High
$117.49
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$316.23
Typical High
$371.54
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$323.59
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$269.15